No abstract

BackgroundOften, interventions targeting the kinematic and temporal and spatial changes in gait commonly seen after a stroke are based on observations of walking. Having the capacity to objectively identify such changes and track improvements over time using reliable and valid measures is important. The Wisconsin Gait Scale (WGS), which is comprised of 14 items, was developed specifically to examine and document gait changes occurring after a stroke. The purpose of the study was to explore the interrater and intrarater reliability and minimal detectable change (MDC) of the WGS when used by physical therapists to examine gait in adults post-stroke.MethodsFourteen physical therapists from 3 different acute inpatient rehabilitation centers rated videotapes of the gait of 6 adults post-stroke using the WGS. To minimize subject variability from fatigue, videotapes created by using 4 cameras provided right and left lateral, anterior, and posterior views of walking on a level surface. One complete ambulation trial from each subject post-stroke, which included 4 views of the same ambulation trial, was examined by the licensed physical therapists using the WGS. An opportunity was provided to review the tool and a practice trial was performed using an additional videotape not included in the analysis. Gait was examined on 2 different occasions separated by a period of approximately 21 days to minimize the effects of recall bias. Intraclass Correlation Coefficients (ICC) were used to examine the interrater and intrarater reliability of the WGS.ResultsInterrater (ICC = 0.83) and intrarater (ICC = 0.91) reliability were both good. The standard error of the measurement (SEM) was 1.47 and the MDC95 was 4.24. There was no statistically significant difference between the scores on the WGS when comparing the 2 different sessions.ConclusionsThe WGS shows promise as an instrument that can make observational gait analysis more reliable. High intrarater reliability and low SEM suggests that the WGS is stable when administered across multiple sessions by the same rater. The ICC for interrater reliability was also good, which suggests that multiple examiners can effectively use the instrument. With minimal training, the physical therapists in the study were able to produce highly reliable results using the WGS to objectively document gait dysfunction.

No abstract

The organization of vestibulocerebellar projections to the flocculonodular and adjacent cortices were studied in Galago using horseradish peroxidase (HRP). Implants of HRP pellets or injections (0.14-0.95 microliter) were placed in floccular, parafloccular, nodular, and uvular cortices. Following survival times of 18-25 hours animals were killed via transcardiac perfusion of heparinized saline followed by a buffered solution of paraformaldehyde and glutaraldehyde. Tissues were processed using DAB as the chromogen. Consequent to floccular implants HRP-positive cells are found bilaterally in medial (MVN), spinal (SpVN), and superior (SVN) vestibular nuclei. Labeled neurons are present in the ipsilateral subgroup y and interstitial nucleus of the eighth nerve. The prepositus hypoglossal nuclei also contained HRP-positive somata. A column of labeled cells is present exclusively in dorsomedial MVN subsequent to injection of the paraflocculus. Injections of nodular cortex reveal a distinct bilateral projection to this cortical area. Many labeled cells are located in SpVN, MVN, SVN, subgroups x and y, the interstitial nucleus, and the ganglion of the eighth nerve. Labeled somata are concentrated in dorsal and dorsolateral SpVN and in a bandlike configuration in subgroup x. HRP-reactive cells appear to have a differential rostrocaudal distribution in MVN, while the majority of positive cells in SVN are found in central portions of the nucleus. After HRP injection into the transition area between nodular and uvular cortices, labeled neurons are present in MVN, SpVN, and the prepositus hypoglossal nucleus. A similar distribution of HRP-positive cells is seen following injections of ventral uvula; however, cells are markedly fewer in number. In no case, subsequent to injection of the flocculonodular lobe and adjacent cortices, are HRP-labeled neurons found in the lateral vestibular nucleus.